Avera Health Plans Prescription Benefits

Avera Health Plans (AHP) contracts with Express Scripts, Inc. (ESI) to provide prescription drug coverage for our fully insured products. ESI’s pharmacy network consists of 57,117 nation-wide pharmacies. This network has been designed to be a large, open, national network and offers members the greatest accessibility. The main objective of this network is to lower costs by providing incentives for generic use.

AHP offers choices of copay plans as well as plans with a separate deductible/coinsurance benefit for prescription drugs. Copay plan options include tiered benefits with formularies and step therapy programs on specific therapeutic classes of drugs to provide a great prescription drug benefit as well as help contain costs. This benefit includes both retail and mail order prescription drugs. You may visit www.expressscripts.com for more information.

For self-funded products offered by Avera Health Plans Benefit Administrators, outside pharmaceutical vendors may be utilized.

View our most commonly used drug formulary.